Concerta Patient Assistance Programs

Concerta: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Concerta. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

The patient must also be permanently residing in the US or US territories.

Application

Obtaining

Call or download

Receiving

Faxed, mailed or downloaded from website

Returning

The completed application can be faxed or mailed back.

Doctor's Action

Complete section and sign

Applicant's Action

Complete section, sign, attach a copy of proof of income

Decision Communicated

Patient and Doctor notified in writing

Decision Timeframe

Not specified

Medication

Amount/Supply

Not specified

Sent To

Doctor's office or patient is sent card to be used at pharmacy

Delivery Time

Varies

Refill Process

Varies per medication

Limit

Varies

Re-application

New application, new documentation yearly

Additional Information

*Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. Please Contact the program for more information (1-800-652-6227).
**Please call 1-800-652-6227 or visit Program website for specific FPL income requirements.